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The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis

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  • Rigmor C Berg
  • Samantha Page
  • Anita Øgård-Repål

Abstract

Background: The practice of involving people living with HIV in the development and provision of healthcare has gained increasing traction. Peer-support for people living with HIV is assistance and encouragement by an individual considered equal, in taking an active role in self-management of their chronic health condition. The objective of this systematic review was to assess the effects of peer-support for people living with HIV. Methods: We conducted a systematic review in accordance with international guidelines. Following systematic searches of eight databases until May 2020, two reviewers performed independent screening of studies according to preset inclusion criteria. We conducted risk of bias assessments and meta-analyses of the available evidence in randomised controlled trials (RCTs). The certainty of the evidence for each primary outcome was evaluated with the Grading of Recommendations Assessment, Development, and Evaluation system. Results: After screening 219 full texts we included 20 RCTs comprising 7605 participants at baseline from nine different countries. The studies generally had low risk of bias. Main outcomes with high certainty of evidence showed modest, but superior retention in care (Risk Ratio [RR] 1.07; Confidence Interval [CI] 95% 1.02–1.12 at 12 months follow-up), antiretroviral therapy (ART) adherence (RR 1.06; CI 95% 1.01–1.10 at 3 months follow-up), and viral suppression (Odds Ratio up to 6.24; CI 95% 1.28–30.5 at 6 months follow-up) for peer-support participants. The results showed that the current state of evidence for most other main outcomes (ART initiation, CD4 cell count, quality of life, mental health) was promising, but too uncertain for firm conclusions. Conclusions: Overall, peer-support with routine medical care is superior to routine clinic follow-up in improving outcomes for people living with HIV. It is a feasible and effective approach for linking and retaining people living with HIV to HIV care, which can help shoulder existing services. Trial registration: CRD42020173433.

Suggested Citation

  • Rigmor C Berg & Samantha Page & Anita Øgård-Repål, 2021. "The effectiveness of peer-support for people living with HIV: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 16(6), pages 1-24, June.
  • Handle: RePEc:plo:pone00:0252623
    DOI: 10.1371/journal.pone.0252623
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    Cited by:

    1. Taverne, Bernard & Laborde-Balen, Gabrièle & Sow, Khoudia & Ndiaye, Ndeye Bineta & Diop, Karim, 2023. "Treatment success or failure in children and adolescents born with HIV in rural Senegal: An anthropological perspective," Social Science & Medicine, Elsevier, vol. 317(C).
    2. Ahmed, Charisse V. & Weissinger, Guy & Teitelman, Anne & Sabelo Dlamini, Ndumiso & Patience Dlamini, Nontsikelelo & Cebsile Dlamini, Thuthukile & Nkambule, Angel & Nkambule, Siphesihle & Brawner, Brid, 2022. "Expert client service delivery practices among adolescents living with HIV in Eswatini: A thematic analysis," Children and Youth Services Review, Elsevier, vol. 132(C).
    3. Nelsensius Klau Fauk & Lillian Mwanri & Karen Hawke & Leila Mohammadi & Paul Russell Ward, 2022. "Psychological and Social Impact of HIV on Women Living with HIV and Their Families in Low- and Middle-Income Asian Countries: A Systematic Search and Critical Review," IJERPH, MDPI, vol. 19(11), pages 1-25, May.
    4. Mullard, Jordan C.R. & Kawalek, Jessica & Parkin, Amy & Rayner, Clare & Mir, Ghazala & Sivan, Manoj & Greenhalgh, Trisha, 2023. "Towards evidence-based and inclusive models of peer support for long covid: A hermeneutic systematic review," Social Science & Medicine, Elsevier, vol. 320(C).

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